Provider Demographics
NPI:1235865163
Name:BRUCE, LAUREN (SSP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:BRUCE
Suffix:
Gender:F
Credentials:SSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16834 BEECHWOOD FOREST WAY
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-4696
Mailing Address - Country:US
Mailing Address - Phone:254-681-4778
Mailing Address - Fax:
Practice Address - Street 1:16834 BEECHWOOD FOREST WAY
Practice Address - Street 2:
Practice Address - City:ATASCOCITA
Practice Address - State:TX
Practice Address - Zip Code:77346-4696
Practice Address - Country:US
Practice Address - Phone:254-681-4778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool